Failure to recognize the severity of an asthmatic attack and its consequent lack of aggressive management have been incriminated as contributing factors in mortality from asthma. We reviewed our experience with patients in status asthmaticus admitted to the Respiratory Intensive Care Unit (RICU) over a nine-year period to determine the course and mortality of patients managed in the RICU. Between May, 1968, and April, 1977, 86 patients in status asthmaticus were admitted, 11 with multiple admissions, for a total of 111 admissions. There were two fatalities recorded. Psychological dependence on therapeutic modalities probably contributed to these two deaths, and both may have been preventable. The low mortality rate probably reflects the more intensive management and monitoring that these severe asthmatics receive in an RICU setting.

Asthma: T. J. H. Clark and S. Godfrey, W. B. Saunders Company, Philadelphia and Toronto, 1977. 409 pages.

A simplified method of studying the surfacing reaction of goldfish to hallucinogens is described. Goldfish weighing up to three grams are injected intracranially. Employing this method, d-lysergic acid diethylamide (LSD-25), d-2-acetyl lysergic acid diethylamide (ALD-52), 1-methyl d-lysergic acid butano-lamide (UML-491), and 5-methoxy dimethyl tryptamine (5-MEO-DMT) were found to be as pharmacologically active as previously noted in fish and in man. The relationship of these drugs to their anti-serotonin activity is of particular interest to the allergist because of the way in which the congeners and derivatives of LSD block the action of serotonin on smooth muscle.

A self-help education-exercise program for asthmatic children and their parents was evaluated in Denver, Colorado. The objective of the program was to instill better self-care practices in the child which are expected to reduce utilization and cost of medical services and reduce the amount of interference in the child's normal activities. The program was designed to educate the family about the nature of asthma and its treatment, the importance of self-responsibility for the child, and the psychosocial aspects which may affect both the child and the parents in a family with an asthmatic child. The program also included specific lessons pertaining to self-care practices including general health exercises on land and in water, relaxation training, and diaphragmatic breathing. The results of subjective evaluations of the parents indicated that the program was successful in achieving its goals to: Reduce the number of severe attacks, reduce medication usage, improve compliance, reduce days of school missed, increase exercise activity, and control wheezing by the steps taught in the course. While the results are suggestive, a further, controlled evaluation of the program is recommended.